Blog

Roman philosopher Pliny the Elder once stated in vino veritas. It took another two thousand years for Europe to get around to putting veritas on its vino. Ireland is currently debating a robust bill to address alcohol harm that includes, for the first time in Europe, a large warning that alcohol increases risk of cancer.

Academic literature has long documented the relationship between cancer and drinking, with the International Agency for Research on Cancer labeling ethanol as a carcinogen back in 1987. However, these findings have been slow to make their way to public consciousness. This may be changing.

As ASCO was making this determination, the province of Yukon in Canada launched a bold experiment: to test cancer-risk warnings in a major liquor store in Whitehorse. Though vast in terrain, Yukon has only around 35,000 residents, allowing Health Canada to fund an experiment comparing buyer behavior in a store that uses the health warnings to ones in stores that sell alcohol as-is. Public health professionals were optimistic about its impact. "If results demonstrate an effect on consumer behavior," Yukon Chief Medical Officer of Health Brendan Hanley, MD, told MedScape, "there is potential for some important policy changes, not just locally but nationally and internationally, to address responsible alcohol consumption."

This message was heard loud and clear by the Canadian alcohol industry, which promptly issued threats of litigation. The province quickly backed down and stripped off the cancer warnings. John Streicker, the Yukon legislator tasked with overseeing the province's state-run liquor stores, was open about the effectiveness of the threat. "We need to do the responsible things," he told the New York Times, "which is to judge whether [litigation] is the best use of our money for our citizens. The hard choice is whether to pay for lawyers or whether to pay for harm reduction."

Yet no sooner had Canada put down the torch then Ireland picked it up. Minister for Health Simon Harris assembled a comprehensive harm minimization bill and put it up for debate. Included in its provisions are minimum unit pricing, restrictions on advertising, and point-of-sale controls. It also calls for at least one-third of the bottle to be covered in health warnings, including warnings that alcohol is a carcinogen. The bill has already passed the Seanad (Ireland's Senate) and is before the other deliberative body, the Dail.

This surge across the English-speaking world of recognition of alcohol's role in cancer has found a home in the United Kingdom as well. In early 2018, the Royal Society for Public Health (RSPH) began agitating for health labeling as well. Shirley Cramer, CBE, of the RSPH noted that 90% of U.K. residents are unaware of alcohol's carcinogenic effects. When it comes to health disclosures, she observed, "alcohol continues to lag behind. If we are to raise awareness and reduce alcohol harm, this must change."

Needless to say, both proposals have raised outrage from Big Alcohol's mouthpieces. A representative of U.K.'s liquor standards body the Portman Group complained that "there was little public interest in a radical overhaul of drinks labelling and strong opposition to cramming more information on packs." The Alcohol Beverage Federation of Ireland likewise complained that cancer advisories would be "devastating for drinks companies," and would cripple the industry "when the sector already faces major uncertainty, with Brexit negotiations ongoing."

Public health advocates should find these complaints heartening. Since these warnings are intended to encourage consumers to drink less and protect their health, Big Alcohol's objections means they are likely to work. Of course, if current behavior is any pattern, the alcohol control world won't know for sure until the first lawsuit is filed.

Some of the worst effects of severe alcohol use kick in later in life, including liver failure, breast cancer, and diabetes. Now, a new French study adds early-onset dementia to the list. The findings, just published in The Lancet, looked at characteristics of 57,353 patients diagnosed with Alzheimer’s and similar conditions before they turned 65 years old. In 38.9% of the cases, dementia was directly due to neurological damage from drinking. In a further 17.6%, the direct link was absent but the patients nonetheless had an alcohol use disorder.

Speaking to the Guardian, Dr. Sara Imarisio of Alzheimer’s Research U.K. cautions that this may actually underrepresent the hazards. “The study … doesn’t reveal the full extent of the link between alcohol use and dementia risk. Previous research has indicated that even moderate drinking may have a negative impact on brain health and people shouldn’t be under the impression that only drinking to the point of hospitalization carries a risk.”

“Every year we have another study showing how the consequences of drinking too much destroy lives,” said Michael Scippa, Public Relations Director of Alcohol Justice. “And every year, Big Alcohol pours another hundred million bucks into telling us how alcohol should be part of a healthy lifestyle. It’s a joke.”

Six cities' plans to paint the town red will splash blood across the whole California map.

Despite outright rejection in last year's legislative cycle, the deep pockets of big nightclub promotion companies have persuaded the California legislature to revisit 4 a.m. last calls. The current version of the bill, still written by Scott Wiener but now labeled SB 905, only permits six cities to extend bar service hours. Those cities are San Francisco, Oakland, Sacramento, West Hollywood, Long Beach, and the City of Los Angeles.

Despite the tweaks to this bill, the problems plaguing it remain obvious. Sensible last call policies are valuable policies that reduce harm without criminalizing drinking. A study on Norway during a period of patchwork last call hours shows that extending them increased assaults by 17% per additional hour. In Sydney, Australia, efforts to deal with runaway chaos from overconsumption inspired a 2-hour reduction in bar hours that reduced violence by 22% to 45%, depending on the area. Other studies on drunk driving shows that 51% more drivers got in alcohol related crashes when leaving bars with extended last calls.

More simply, keeping a bar open later means the people there will have drunk more. Far from being under debate, more drinking underlies the ostensible economic benefits accruing the handful of massive nightclubs that are sponsoring this bill. What these operators, and their reckless proxy, Sen. Wiener, are trying to hide is how easily they will avoid any of the consequences. Instead, these consequences will be borne by the tens of millions of Californians outside these newfound "party zones," as drunk drivers pour out of the city center and into quiet outlying communities. The results will be disruptive and expensive at best, lethal at worst.

In California, fatal alcohol-related crashes an ongoing crisis. According to the California Office of Traffic Safety, fully 20% more people died in alcohol-related crashes in 2016 than 2014. At the rate fatal crashes are increasing, the death toll will double between 2016 and 2024. This spike persists despite efforts to promote designated drivers, despite the claims of ride-sharing services… and despite the vacant platitudes of SB 905 supporters who want to profit and while hoping someone else deals with the aftermath.

By definition, DUIs do not occur at the place where the driver got drunk. Ventura County alone out of all California counties tracks the behaviors of drunk drivers going through its DUI diversion programs. They found that drivers had traveled an average of 7 miles before getting arrested, with a maximum of 150 miles. Around 15% of young adults were arrested returning from either Hollywood or Santa Barbara-both at least 30 miles from the Ventura County border.

With that in mind, Alcohol Justice assembled the Splash Maps for SB 905. These maps show 7-mile and 40-mile "splash zones" where the drunk driving damage will occur. In addition, we compiled lists of cities within the splash zones. (If you feel your community was not included in the list and should be, please let us know.)